Mechanisms of Venous Occlusion During Canine Penile Erection: An Anatomic Demonstration

Hemodynamic studies have clearly demonstrated that intracorporeal injection of papaverine causes an increase of venous outflow resistance, and we therefore undertook a study of the venous drainage of the canine penis to delineate the anatomic changes in the venular structure during papaverine-induced erection. In 11 dogs, the corpora cavernosa were examined by corrosion casting in six and serial trichrome staining and histologic sectioning in five. Low-power scanning electron microscopy of the corrosion casts demonstrated the existence of a venular plexus interposed between the tunica albuginea and the sinusoidal spaces. After papaverine injection, this subalbugineal venular plexus is compressed between the dilated sinusoids from below and the tunica albuginea from above, such that venous drainage is effectively impeded. Examination of two cadaveric human penile corrosion casts by low-power scanning electron microscopy revealed evidence of a similar subalbugineal venular plexus draining into the emissary veins along the shaft of the penis. Based on the above, a model for the anatomic basis of venous occlusion during penile erection is outlined. Along with arteriolar and sinusoidal smooth-muscle relaxation, this can account for the three basic hemodynamic changes necessary for erection: increased arterial inflow, increased intracorporeal pressure, and increased venous outflow resistance.